Delirprävention und -management durch Pflegekonsile – eine Implementierungsstrategie

Delirium has a probability of occurrence of 10–25% in elderly patients in acute care hospitals and requires immediate treatment to minimize subsequent damage such as loss of everyday functioning and cognition and even dementia. Nonpharmacological delirium prevention and management programs can reduce the prevalence and duration of delirium.

The aim of this study was to evaluate the implementation of delirium care consultations as a gateway to delirium prevention and management in the departments of cardiovascular diseases (HGK), neurosurgery (NC), and trauma surgery/orthopedics (UCO).

From 01.01.2021 to 31.12.2022, the penetration rate of delirium management was determined on the basis of care consultations. The aim was to register at least 10% of inpatients aged 65 and over and to mention delirium in the doctor’s letter in the event of a positive assessment (CAM).

A total of 846 patients were registered with the Delirium Prevention and Management Team AKTIVER (2021: NC n = 133, 14.5%; HGK n = 141, 14.66%; UCO n = 108, 17.7%). In the second year, registrations increased by 22.29% (n = 145) and 43.11% (n = 244) in the NC and HGK departments, respectively. Delirium was detected in 328 patients (CAM positive), and a total of 422 (41%) were cared for by AKTIVER. Fewer than 30% of the detected delirium cases were mentioned in the doctor’s letter (28.07% NC; 32.69% HGK, and 16.66% UCO), and 32.32% were ICD coded.

The successful implementation of a delirium care consultation service is reflected in the penetration rate of 17.17%. The service proved to be suitable for implementing delirium prevention and management measures promptly. However, the diagnosis of delirium was only occasionally coded or mentioned in the doctor’s letter, making further treatment by the general practitioner (secondary delirium prevention) more difficult.